Provider Demographics
NPI:1528414224
Name:LINDA HOLMBERG, LLC
Entity Type:Organization
Organization Name:LINDA HOLMBERG, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:334-546-8970
Mailing Address - Street 1:4252 CARMICHAEL RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-2804
Mailing Address - Country:US
Mailing Address - Phone:334-546-8970
Mailing Address - Fax:334-272-8003
Practice Address - Street 1:4252 CARMICHAEL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2804
Practice Address - Country:US
Practice Address - Phone:334-546-8970
Practice Address - Fax:334-272-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2136251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health